[Population-based heart infarct register in the Augsburg region: possibilities and limitations].

Special procedures were developed to establish the Augsburg Coronary Event Register in accordance with the German data confidentiality laws. Contracts with the 26 hospitals in the study region and the adjacent ares (registration of 95% of all acute myocardial infarctions (AMI)) were specified to ensure their cooperation with the MONICA Project (WHO project Monitoring Trends and Determinants in Cardiovascular Disease). Written consent of the patients, declaring their participation in the project is required. Fatal events with suspected AMI within the study region (4% of male and 7% of female coronary deaths occur outside the region) are selected from the information in the anonymous death certificates provided by the three regional health departments. Each health department allocates an identification (ID) number to each event and sends a questionnaire for cause of death validation (MONICA questionnaire) to the last attending physician and/or the coroner. The register receives this information in anonymous form and links the MONICA questionnaire and the death certificate by means of the ID number. While data confidentiality laws do not impair case finding, they do restrict the validation of the diagnosis and person-based registration. The inclusion of fatal events with insufficient data on cause of death (25% of all registered fatal events) seems prudent to avoid underestimating attack rates and mortality, i.e. the AMI risk for the resident study population.